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coronary microvascular dysfunction

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https://www.readbyqxmd.com/read/29774406/reduced-global-myocardial-perfusion-reserve-in-dcm-and-hcm-patients-assessed-by-cmr-based-velocity-encoded-coronary-sinus-flow-measurements-and-first-pass-perfusion-imaging
#1
Michael Bietenbeck, Anca Florian, Zornitsa Shomanova, Claudia Meier, Ali Yilmaz
BACKGROUND: Coronary microvascular dysfunction (CMD) is an independent predictor of poor prognosis in patients suffering from dilative or hypertrophic cardiomyopathy (DCM/HCM). To assess CMD, quantitative myocardial first-pass perfusion (1P) cardiovascular magnetic resonance (CMR) can be performed. Coronary sinus flow (CSF) measurements at rest and during maximal vasodilatation are an alternative and well-validated approach for the quantification of global myocardial blood flow (MBF) in CMR...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29761309/is-there-a-role-for-cardiac-positron-emission-tomography-in-hypertrophic-cardiomyopathy
#2
Paco E Bravo
Coronary microvascular dysfunction and, its functional consequence, myocardial ischemia are common pathologic features in patients with hypertrophic cardiomyopathy (HCM). Both have been commonly invoked as potential triggers of and/or contributors to the underlying pathophysiological processes leading to heart failure, and malignant ventricular arrhythmias. Positron emission tomography (PET) with myocardial blood flow quantification provides a unique opportunity to evaluate the integrity and function of the coronary microcirculation in HCM...
May 14, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29747829/local-low-shear-stress-and-endothelial-dysfunction-in-patients-with-nonobstructive-coronary-atherosclerosis
#3
Gerasimos Siasos, Jaskanwal D Sara, Marina Zaromytidou, Kyoung H Park, Ahmet Umit Coskun, Lilach O Lerman, Evangelos Oikonomou, Charles C Maynard, Dimitris Fotiadis, Kostas Stefanou, Michail Papafaklis, Lampros Michalis, Charles Feldman, Amir Lerman, Peter H Stone
BACKGROUND: Local hemodynamic factors are important determinants of atherosclerotic plaque development and progression. OBJECTIVES: The goal of this study was to determine the association between low endothelial shear stress (ESS) and microvascular and epicardial endothelial dysfunction in patients with early atherosclerosis. METHODS: Sixty-five patients (mean age 52 ± 11 years) with nonobstructive coronary atherosclerosis (luminal diameter stenosis <30%) were included...
May 15, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29744011/noninvasive-evaluation-of-symptomatic-women-with-suspected-coronary-artery-disease
#4
REVIEW
Mohammed A Chamsi-Pasha, Karla M Kurrelmeyer
Cardiovascular disease (CVD) is the leading cause of death in the United States, yet several factors make it challenging to diagnose in women. Although women have more frequent chest pain than men, atypical symptoms such as nausea, dyspnea, and fatigue make it difficult to determine their risk of coronary artery disease (CAD) before testing. Current guidelines recommend exercise electrocardiography (ex-ECG) as the initial test in symptomatic women with intermediate pretest probability who can exercise and have a normal resting ECG; however, treadmill ex-ECG testing has a significantly lower positive predictive value in women...
October 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29732488/coronary-flow-reserve-in-systemic-rheumatic-diseases-a-systematic-review-and-meta-analysis
#5
REVIEW
Gian Luca Erre, Giorgio Buscetta, Panagiotis Paliogiannis, Arduino Aleksander Mangoni, Ciriaco Carru, Giuseppe Passiu, Angelo Zinellu
Coronary flow reserve (CFR), a measure of both obstructive coronary artery disease and microvascular dysfunction, has been evaluated in systemic rheumatic diseases (RDs), but a comprehensive critical appraisal of the available evidence is lacking. The objective of this study is to conduct a systematic review and meta-analysis of studies with small sample size investigating the associations between the presence of RDs and CFR to increase statistical power and accuracy. PubMed, Web of Science, Scopus, and Google Scholar, from inception to March 2018, were searched for studies reporting on CFR in RDs in comparison to healthy subjects...
May 7, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29728013/coronary-and-peripheral-vasomotor-responses-to-mental-stress
#6
Muhammad Hammadah, Jeong Hwan Kim, Ibhar Al Mheid, Ayman Samman Tahhan, Kobina Wilmot, Ronnie Ramadan, Ayman Alkhoder, Mohamed Khayata, Girum Mekonnen, Oleksiy Levantsevych, Yasir Bouchi, Belal Kaseer, Fahad Choudhary, Mohamad M Gafeer, Frank E Corrigan, Amit J Shah, Laura Ward, Michael Kutner, J Douglas Bremner, David S Sheps, Paolo Raggi, Viola Vaccarino, Habib Samady, Kreton Mavromatis, Arshed A Quyyumi
BACKGROUND: Coronary microvascular dysfunction may contribute to myocardial ischemia during mental stress (MS). However, the role of coronary epicardial and microvascular function in regulating coronary blood flow (CBF) responses during MS remains understudied. We hypothesized that coronary vasomotion during MS is dependent on the coronary microvascular endothelial function and will be reflected in the peripheral microvascular circulation. METHODS AND RESULTS: In 38 patients aged 59±8 years undergoing coronary angiography, endothelium-dependent and endothelium-independent coronary epicardial and microvascular responses were measured using intracoronary acetylcholine and nitroprusside, respectively, and after MS induced by mental arithmetic testing...
May 3, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29725598/takotsubo-cardiomyopathy-one-more-angiographic-evidence-of-microvascular-dysfunction
#7
Marco Loffi, Andrea Santangelo, Martin Kozel, Viktor Kocka, Tomas Budesinsky, Libor Lisa, Petr Tousek
Background: Takotsubo cardiomyopathy (TC) aetiology has not been completely understood yet. One proposed pathogenic mechanism was coronary microvascular dysfunction (MVD). This study compared coronary flow and myocardial perfusion in patients with TC, microvascular angina (MVA), and a control group (CG). Methods: Out of 42 consecutive patients presented to our centre with TC from 2013 to 2017; we retrospectively selected 27 patients. We compared them with a sex- and age-matched group of 27 MVA cases and 27 patients with normal coronary arteries (CG)...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29716756/coronary-microvascular-dysfunction-in-patients-with-stable-coronary-artery-disease-the-ce-marc-2-coronary-physiology-sub-study
#8
David Corcoran, Robin Young, David Adlam, Alex McConnachie, Kenneth Mangion, David Ripley, David Cairns, Julia Brown, Chiara Bucciarelli-Ducci, Andreas Baumbach, Rajesh Kharbanda, Keith G Oldroyd, Gerry P McCann, John P Greenwood, Colin Berry
BACKGROUND: In patients with angina undergoing invasive management, no obstructive coronary artery disease (NOCAD) is a common finding, and angina may persist following percutaneous coronary intervention (PCI). Coronary microvascular dysfunction may be relevant. We aimed to assess the proportion of patients presenting with suspected CAD who had coronary microvascular dysfunction. METHODS: Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease 2 (CE-MARC 2) was a prospective multicenter randomised controlled trial of functional imaging versus guideline-based management in patients with suspected CAD...
April 19, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29706554/-deferred-versus-immediate-stenting-in-patients-with-st-segment-elevation-myocardial-infarction-and-residual-large-thrombus-burden-reclassified-in-the-culprit-lesion
#9
Piero Custodio-Sánchez, Félix Damas-De Los Santos, Marco A Peña-Duque, Daniel Coutiño-Castelán, Eduardo Arias-Sánchez, Arturo Abundes-Velasco, Oscar Castro-Alvarado, Franklyn A Colon-Arias, Carlos Alvarenga-Fajardo, César Hernández-Fonseca, Erika Rodríguez-Barriga, Adolfo Hernández-Padilla
BACKGROUND: Reclassification of a large thrombus burden is an independent predictor of major adverse cardiac events and no-reflow in patients with ST- segment elevation myocardial infarction (STEMI). Patients with a greater residual thrombus burden have worse microvascular dysfunction and greater myocardial damage. METHODS: A retrospective analysis was performed on 833 STEMI patients who underwent primary percutaneous coronary intervention. The final residual thrombus burden was reclassified after the lesion was wired, and a thrombus aspiration or balloon dilatation was performed to restore and stabilise a thrombolysis in myocardial infarction (TIMI) 2-3 flow...
April 26, 2018: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/29687698/microcirculatory-dysfunction-in-the-heart-and-the-brain
#10
Hernán Mejía-Rentería, Jordi A Matias-Guiu, Francesco Lauri, Miguel Yus, Javier Escaned
Coronary microcirculatory dysfunction is a major cause of myocardial ischemia that influences the outcomes of patients with coronary artery disease. The mechanisms of coronary microcirculatory dysfunction are heterogeneous and may result from a spectrum of biological and cardiovascular risk factors that may affect also the microcirculation of other vital organs. Microcirculatory dysfunction of the brain, known as cerebral small vessel disease, is increasingly being recognized as a cause of cognitive decline and neurodegenerative disorders...
April 20, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29680355/index-of-microcirculatory-resistance-as-a-tool-to-characterize-microvascular-obstruction-and-to-predict-infarct-size-regression-in-patients-with-stemi-undergoing-primary-pci
#11
Giovanni Luigi De Maria, Mohammad Alkhalil, Mathias Wolfrum, Gregor Fahrni, Alessandra Borlotti, Lisa Gaughran, Sam Dawkins, Jeremy P Langrish, Andrew J Lucking, Robin P Choudhury, Italo Porto, Filippo Crea, Erica Dall'Armellina, Keith M Channon, Rajesh K Kharbanda, Adrian P Banning
OBJECTIVES: This study aimed to compare the value of the index of microcirculatory resistance (IMR) and microvascular obstruction (MVO) measured by cardiac magnetic resonance (CMR) in patients treated for and recovering from ST-segment elevation myocardial infarction. BACKGROUND: IMR can identify patients with microvascular dysfunction acutely after primary percutaneous coronary intervention (pPCI), and a threshold of >40 has been shown to be associated with an adverse clinical outcome...
April 14, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29605246/influence-of-local-myocardial-damage-on-index-of-microcirculatory-resistance-and-fractional-flow-reserve-in-target-and-nontarget-vascular-territories-in-a-porcine-microvascular-injury-model
#12
Joo Myung Lee, Hyun Kuk Kim, Kyung Seob Lim, Jun-Kyu Park, Ki Hong Choi, Jonghanne Park, Doyeon Hwang, Tae-Min Rhee, Jeong Hoon Yang, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Joo-Yong Hahn, Bon-Kwon Koo, Myung Ho Jeong
OBJECTIVES: The aim of this study was to investigate the influence of microvascular damage in one vessel territory on invasively measured physiological parameters in the other vessel, using a porcine microvascular damage model. BACKGROUND: Although fractional flow reserve (FFR)-guided decision-making for the nonculprit stenosis in patients with acute myocardial infarction has been reported to be better than angiography-guided revascularization, there have been debates regarding the influence of microvascular dysfunction on measured FFR in nonculprit vessels...
March 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29605243/diagnostic-and-prognostic-efficacy-of-coronary-flow-capacity-obtained-using-pressure-temperature-sensor-tipped-wire-derived-physiological-indices
#13
Rikuta Hamaya, Taishi Yonetsu, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hoshino, Masao Yamaguchi, Masahiro Hada, Yoshinori Kanno, Tadashi Murai, Kenzo Hirao, Tsunekazu Kakuta
OBJECTIVES: This study aimed to evaluate the feasibility and efficacy of pressure-temperature sensor-tipped wire-derived coronary flow capacity (PTW-CFC) for assessing flow impairment and prognosis. BACKGROUND: CFC provides an integrated coronary physiological assessment in which coronary flow reserve and coronary flow during hyperemia are organized. METHODS: A total of 643 native de novo lesions for which physiological assessments were performed using a PressureWire (St...
March 23, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29598865/pet-assessment-of-epicardial-intimal-disease-and-microvascular-dysfunction-in-cardiac-allograft-vasculopathy
#14
Sharon Chih, Aun Yeong Chong, Fernanda Erthal, Robert A deKemp, Ross A Davies, Ellamae Stadnick, Derek Y So, Christopher Overgaard, George Wells, Lisa M Mielniczuk, Rob S B Beanlands
BACKGROUND: Cardiac allograft vasculopathy (CAV) is a leading cause of graft failure and death after heart transplantation. Absolute myocardial blood flow (MBF) quantification using rubidium 82 (Rb-82) positron emission tomography (PET) could enable evaluation of diagnostically challenging diffuse epicardial and microvascular disease in CAV. OBJECTIVES: The authors aimed to evaluate Rb-82 PET detection of CAV. METHODS: Consecutive transplant recipients undergoing coronary angiography were prospectively evaluated with PET, multivessel intravascular ultrasound (IVUS), and intracoronary hemodynamics...
April 3, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29589674/reperfusion-in-stemi-patients-still-a-role-for-cardioprotection
#15
Filippo Ottani, Ugo Limbruno, Roberto Latini, Leonardo Misuraca, Marcello Galvani
Ischemic heart disease remains a leading cause of death worldwide, responsible for an estimated 17.5 million deaths in 2012. Mortality from St-elevation myocardial infarction STEMI have decreased over the last 3 decades. However, despite the success of reperfusion therapy by primary percutaneous coronary intervention (PPCI) or thrombolysis, STEMI is still of significant concern. A recent patient-level meta-analysis emphasized the pivotal importance of infarct size within 1 month after PPCI as a determinant of all-cause mortality and hospitalization for heart failure at 1 year...
March 28, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29589528/flavonols-and-flavones-protecting-against-myocardial-ischemia-reperfusion-injury-by-targeting-protein-kinases
#16
Owen L Woodman, Kai Yee Chin, Colleen J Thomas, Dominic C H Ng, Clive N May
In acute myocardial infarction (AMI) the first line of treatment is to rapidly restore blood flow to the ischemic myocardium to limit infarct size. It is now well established that though clearly beneficial the positive outcomes of this intervention are limited by injury in response to the reperfusion itself in addition to the prior ischemia. This process is described as reperfusion injury and is considered to contribute to the arrhythmias, microvascular dysfunction and impaired cardiac contractility that is observed even after the restoration of coronary blood flow...
March 26, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29571424/optimizing-risk-stratification-and-noninvasive-diagnosis-of-ischemic-heart-disease-in-women
#17
REVIEW
Habibat A Garuba, Fernanda Erthal, Ellamae Stadnick, Atif Alzahrani, Benjamin Chow, Robert deKemp, Rob S Beanlands
Ischemic heart disease (IHD) is an important and previously underappreciated cause of significant morbidity and mortality in women. Key differences exist in the pathophysiology, sex-specific risk factors, and clinical presentation in women compared with men, which influence diagnostic accuracy and utility of pretest risk assessments and noninvasive testing. Women are disproportionately affected by ischemia from microvascular dysfunction as evidenced by having less obstructive coronary artery disease on angiography, contributing to the challenge in diagnosis and prognosis of IHD in women via conventional methods, which tend to emphasize detection of epicardial stenoses...
April 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29557104/functional-approach-for-coronary-artery-disease-filling-the-gap-between-evidence-and-practice
#18
REVIEW
Joo Myung Lee, Joon Hyung Doh, Chang Wook Nam, Eun Seok Shin, Bon Kwon Koo
The presence of myocardial ischemia is the most important prognostic factor in patients with coronary artery disease, and ischemia-directed revascularization has been a standard of care. Fractional flow reserve (FFR) is an invasive method used to detect the functionally significant epicardial coronary stenosis, and FFR-guided revascularization strategy has been proven to be superior to angiography-guided strategy. Recently, a hyperemia-free index, instantaneous wave free ratio (iFR), was developed and showed its non-inferiority for clinical outcomes compared with FFR-guided strategy...
March 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29547025/a-chicken-and-egg-conundrum-coronary-microvascular-dysfunction-and-heart-failure-with-preserved-ejection-fraction
#19
Vahagn Ohanyan, Hamayak Sisakian, Punita Peketi, Ankur Parikh, William M Chilian
No abstract text is available yet for this article.
March 16, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29543037/prevalence-and-characteristics-of-coronary-microvascular-dysfunction-among-chest-pain-patients-in-the-emergency-department
#20
Basmah Safdar, Gail D'Onofrio, James Dziura, Raymond R Russell, Caitlin Johnson, Albert J Sinusas
AIMS: Coronary microvascular dysfunction (CMD) is common in patients with non-obstructive coronary arteries but has not been described in low-risk symptomatic patients. We therefore assessed the prevalence and characteristics of CMD in low to moderate risk patients with chest pain in an emergency department. METHODS AND RESULTS: We used three-dimensional Rb82 cardiac positron emission tomography/computed tomography to diagnose coronary artery disease (known or new regional defect, any coronary calcification) and CMD (low coronary flow reserve without coronary artery disease) in chest pain patients after being ruled out for acute myocardial infarction...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
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